Individual provider Active NPI

Mary Ellen Monaco, D.O.

  • Neurology Physician
  • Joliet, IL
National Provider Identifier
1972607497
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036096928 Issued in IL
Practice address
79 129TH Infantry Dr
Joliet, IL 60435-5134
Phone
(815) 730-1541
Fax
(815) 744-8632
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036096928 IL Primary

Addresses

Primary practice location

79 129TH Infantry Dr
Joliet, IL 60435-5134

Mailing address

79 129TH Infantry Dr
Joliet, IL 60435-5134
Phone (815) 730-1541

Other identifiers 1

IdentifierTypeStateIssuer
036096928MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050223000703 IL Practitioner - Neurology 8224081831 Practice locations: Joliet, IL

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Midwestern University, Chicago College of Osteopathic Med, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

79 N 129TH Infantry Dr
Joliet, IL 60435-5134
Phone (815) 730-1541

Hospital & facility affiliations

  • Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Morris Hospital & Healthcare Centers Hospital, Morris, IL, CCN 140101

Merit-based Incentive Payment System (MIPS)

Final score
21.54 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
71.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036096928ILMDNeurology Physician

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1972607497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 129TH INFANTRY DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355134",
            "telephone_number": "815-730-1541",
            "fax_number": "815-744-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 129TH INFANTRY DR",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355134",
            "telephone_number": "815-730-1541",
            "fax_number": "815-744-8632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONACO",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036096928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096928",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.